Autoimmune vertigo: an update on vestibular disorders associated with autoimmune mechanisms.

Related Articles

Autoimmune vertigo: an update on vestibular disorders associated with autoimmune mechanisms.

Immunol Res. 2018 Oct 01;:

Authors: Russo FY, Ralli M, De Seta D, Mancini P, Lambiase A, Artico M, de Vincentiis M, Greco A

Abstract
The role of the immune system in mediating cochleovestibular pathologies has received increasing attention in recent years. Autoimmune vertigo may be an invalidating condition and may worsen the quality of life of affected patients, especially in the cases of delayed diagnosis. Since the etiopathogenesis is still not clear, also the treatment is not yet completely delineated. According to the clinical presentation, autoimmune vertigo can present as an isolated disorder or in association with systemic autoimmune diseases. The main feature in autoimmune vertigo is the presence of an abnormal immune response, in either absence or presence of systemic autoimmune disease, directed against delicate components of the inner ear. This may determine a functional or anatomical alteration, with an inflammatory reaction often devastating for hearing and balance. Being the exact pathogenesis unknown, the diagnosis of autoimmune vertigo is based either on clinical criteria or on a positive response to steroids. The earlier the diagnosis is made, the sooner the therapy can be installed, giving a chance to the recovery of inner ear damages. Corticosteroids represent the most effective and universally accepted treatment, even if other immunomodulatory drugs are now having a more extensive use.
HIGHLIGHTS: Vertigo is relatively frequent in autoimmune diseases; however, it is often misdiagnosed or attributed to central nervous system alterations rather to specific inner ear involvement. Vertigo and other audiovestibular symptoms may be the first manifestation of an autoimmune disease and if correctly addressed could significantly contribute to early diagnosis of the underlying autoimmune disease. Early diagnosis of immune-related vertigo can lead to prompt initiation of targeted therapy with elevate chances of preventing irreversible damages to the inner ear. The presence of alternating phases of well-being and disabling symptoms in patients with vertigo should always been considered, as they could suggest an underlying autoimmune condition.

PMID: 30270399 [PubMed - as supplied by publisher]

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Feature Maps of the Acoustic Spectrum of the Voice.

Related Articles

Feature Maps of the Acoustic Spectrum of the Voice.

J Voice. 2018 Sep 27;:

Authors: Pabon P, Ternström S

Abstract
The change in the spectrum of sustained /a/ vowels was mapped over the voice range from low to high fundamental frequency and low to high sound pressure level (SPL), in the form of the so-called voice range profile (VRP). In each interval of one semitone and one decibel, narrowband spectra were averaged both within and across subjects. The subjects were groups of 7 male and 12 female singing students, as well as a group of 16 untrained female voices. For each individual and also for each group, pairs of VRP recordings were made, with stringent separation of the modal/chest and falsetto/head registers. Maps are presented of eight scalar metrics, each of which was chosen to quantify a particular feature of the voice spectrum, over fundamental frequency and SPL. Metrics 1 and 2 chart the role of the fundamental in relation to the rest of the spectrum. Metrics 3 and 4 are used to explore the role of resonances in relation to SPL. Metrics 5 and 6 address the distribution of high frequency energy, while metrics 7 and 8 seek to describe the distribution of energy at the low end of the voice spectrum. Several examples are observed of phenomena that are difficult to predict from linear source-filter theory, and of the voice source being less uniform over the voice range than is conventionally assumed. These include a high-frequency band-limiting at high SPL and an unexpected persistence of the second harmonic at low SPL. The two voice registers give rise to clearly different maps. Only a few effects of training were observed, in the low frequency end below 2kHz. The results are of potential interest in voice analysis, voice synthesis and for new insights into the voice production mechanism.

PMID: 30269894 [PubMed - as supplied by publisher]

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Evaluation of Mandarin Chinese Speech Recognition in Adults with Cochlear Implants Using the Spectral Ripple Discrimination Test.

Related Articles

Evaluation of Mandarin Chinese Speech Recognition in Adults with Cochlear Implants Using the Spectral Ripple Discrimination Test.

Med Sci Monit. 2018 May 28;24:3557-3563

Authors: Dai C, Zhao Z, Shen W, Zhang D, Lei G, Qiao Y, Yang S

Abstract
BACKGROUND The aim of this study was to explore the value of the spectral ripple discrimination test in speech recognition evaluation among a deaf (post-lingual) Mandarin-speaking population in China following cochlear implantation. MATERIAL AND METHODS The study included 23 Mandarin-speaking adult subjects with normal hearing (normal-hearing group) and 17 deaf adults who were former Mandarin-speakers, with cochlear implants (cochlear implantation group). The normal-hearing subjects were divided into men (n=10) and women (n=13). The spectral ripple discrimination thresholds between the groups were compared. The correlation between spectral ripple discrimination thresholds and Mandarin speech recognition rates in the cochlear implantation group were studied. RESULTS Spectral ripple discrimination thresholds did not correlate with age (r=-0.19; p=0.22), and there was no significant difference in spectral ripple discrimination thresholds between the male and female groups (p=0.654). Spectral ripple discrimination thresholds of deaf adults with cochlear implants were significantly correlated with monosyllabic recognition rates (r=0.84; p=0.000). CONCLUSIONS In a Mandarin Chinese speaking population, spectral ripple discrimination thresholds of normal-hearing individuals were unaffected by both gender and age. Spectral ripple discrimination thresholds were correlated with Mandarin monosyllabic recognition rates of Mandarin-speaking in post-lingual deaf adults with cochlear implants. The spectral ripple discrimination test is a promising method for speech recognition evaluation in adults following cochlear implantation in China.

PMID: 29806954 [PubMed - indexed for MEDLINE]

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Autoimmune vertigo: an update on vestibular disorders associated with autoimmune mechanisms.

Related Articles

Autoimmune vertigo: an update on vestibular disorders associated with autoimmune mechanisms.

Immunol Res. 2018 Oct 01;:

Authors: Russo FY, Ralli M, De Seta D, Mancini P, Lambiase A, Artico M, de Vincentiis M, Greco A

Abstract
The role of the immune system in mediating cochleovestibular pathologies has received increasing attention in recent years. Autoimmune vertigo may be an invalidating condition and may worsen the quality of life of affected patients, especially in the cases of delayed diagnosis. Since the etiopathogenesis is still not clear, also the treatment is not yet completely delineated. According to the clinical presentation, autoimmune vertigo can present as an isolated disorder or in association with systemic autoimmune diseases. The main feature in autoimmune vertigo is the presence of an abnormal immune response, in either absence or presence of systemic autoimmune disease, directed against delicate components of the inner ear. This may determine a functional or anatomical alteration, with an inflammatory reaction often devastating for hearing and balance. Being the exact pathogenesis unknown, the diagnosis of autoimmune vertigo is based either on clinical criteria or on a positive response to steroids. The earlier the diagnosis is made, the sooner the therapy can be installed, giving a chance to the recovery of inner ear damages. Corticosteroids represent the most effective and universally accepted treatment, even if other immunomodulatory drugs are now having a more extensive use.
HIGHLIGHTS: Vertigo is relatively frequent in autoimmune diseases; however, it is often misdiagnosed or attributed to central nervous system alterations rather to specific inner ear involvement. Vertigo and other audiovestibular symptoms may be the first manifestation of an autoimmune disease and if correctly addressed could significantly contribute to early diagnosis of the underlying autoimmune disease. Early diagnosis of immune-related vertigo can lead to prompt initiation of targeted therapy with elevate chances of preventing irreversible damages to the inner ear. The presence of alternating phases of well-being and disabling symptoms in patients with vertigo should always been considered, as they could suggest an underlying autoimmune condition.

PMID: 30270399 [PubMed - as supplied by publisher]

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Feature Maps of the Acoustic Spectrum of the Voice.

Related Articles

Feature Maps of the Acoustic Spectrum of the Voice.

J Voice. 2018 Sep 27;:

Authors: Pabon P, Ternström S

Abstract
The change in the spectrum of sustained /a/ vowels was mapped over the voice range from low to high fundamental frequency and low to high sound pressure level (SPL), in the form of the so-called voice range profile (VRP). In each interval of one semitone and one decibel, narrowband spectra were averaged both within and across subjects. The subjects were groups of 7 male and 12 female singing students, as well as a group of 16 untrained female voices. For each individual and also for each group, pairs of VRP recordings were made, with stringent separation of the modal/chest and falsetto/head registers. Maps are presented of eight scalar metrics, each of which was chosen to quantify a particular feature of the voice spectrum, over fundamental frequency and SPL. Metrics 1 and 2 chart the role of the fundamental in relation to the rest of the spectrum. Metrics 3 and 4 are used to explore the role of resonances in relation to SPL. Metrics 5 and 6 address the distribution of high frequency energy, while metrics 7 and 8 seek to describe the distribution of energy at the low end of the voice spectrum. Several examples are observed of phenomena that are difficult to predict from linear source-filter theory, and of the voice source being less uniform over the voice range than is conventionally assumed. These include a high-frequency band-limiting at high SPL and an unexpected persistence of the second harmonic at low SPL. The two voice registers give rise to clearly different maps. Only a few effects of training were observed, in the low frequency end below 2kHz. The results are of potential interest in voice analysis, voice synthesis and for new insights into the voice production mechanism.

PMID: 30269894 [PubMed - as supplied by publisher]

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via IFTTT

Evaluation of Mandarin Chinese Speech Recognition in Adults with Cochlear Implants Using the Spectral Ripple Discrimination Test.

Related Articles

Evaluation of Mandarin Chinese Speech Recognition in Adults with Cochlear Implants Using the Spectral Ripple Discrimination Test.

Med Sci Monit. 2018 May 28;24:3557-3563

Authors: Dai C, Zhao Z, Shen W, Zhang D, Lei G, Qiao Y, Yang S

Abstract
BACKGROUND The aim of this study was to explore the value of the spectral ripple discrimination test in speech recognition evaluation among a deaf (post-lingual) Mandarin-speaking population in China following cochlear implantation. MATERIAL AND METHODS The study included 23 Mandarin-speaking adult subjects with normal hearing (normal-hearing group) and 17 deaf adults who were former Mandarin-speakers, with cochlear implants (cochlear implantation group). The normal-hearing subjects were divided into men (n=10) and women (n=13). The spectral ripple discrimination thresholds between the groups were compared. The correlation between spectral ripple discrimination thresholds and Mandarin speech recognition rates in the cochlear implantation group were studied. RESULTS Spectral ripple discrimination thresholds did not correlate with age (r=-0.19; p=0.22), and there was no significant difference in spectral ripple discrimination thresholds between the male and female groups (p=0.654). Spectral ripple discrimination thresholds of deaf adults with cochlear implants were significantly correlated with monosyllabic recognition rates (r=0.84; p=0.000). CONCLUSIONS In a Mandarin Chinese speaking population, spectral ripple discrimination thresholds of normal-hearing individuals were unaffected by both gender and age. Spectral ripple discrimination thresholds were correlated with Mandarin monosyllabic recognition rates of Mandarin-speaking in post-lingual deaf adults with cochlear implants. The spectral ripple discrimination test is a promising method for speech recognition evaluation in adults following cochlear implantation in China.

PMID: 29806954 [PubMed - indexed for MEDLINE]

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Parental separation and parental mental health in childhood and tinnitus and hyperacusis disability in adulthood: a retrospective exploratory analysis.

Parental separation and parental mental health in childhood and tinnitus and hyperacusis disability in adulthood: a retrospective exploratory analysis.

Int J Audiol. 2018 Oct 01;:1-6

Authors: Aazh H, Langguth B, Danesh AA

Abstract
OBJECTIVES: To explore the relationships between parental separation and parental mental health in childhood with tinnitus and hyperacusis disability in adulthood.
DESIGN: Retrospective cross-sectional.
STUDY SAMPLE: The data for consecutive patients who attended a tinnitus and hyperacusis clinic in the UK over a six months period were included (n = 184).
RESULTS: 14.7% of patients reported that while they were growing up, their parents were separated or divorced. There were no significant differences in Tinnitus Handicap Inventory (THI) and Hyperacusis Questionnaire (HQ) between patients with and without history of parental separation. About 40.2% reported history of mental health disorders in their parents. The scores on THI and HQ were worse in the group that reported mental health disorders in their parents (p < .01). Parental mental health illness did not significantly relate to THI, however, it was significantly related to the risk of hyperacusis (odds ratio [OR], after adjusting for age and gender: 2.05, p = .026). The adjusted OR for a subgroup of patients with a diagnosis of hyperacusis was 6.7 (p = .011), indicating a stronger relationship for this subgroup.
CONCLUSIONS: Among patients seeking help for their tinnitus and hyperacusis, poor parental mental health was associated with increased hyperacusis disability.

PMID: 30272507 [PubMed - as supplied by publisher]

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Parental separation and parental mental health in childhood and tinnitus and hyperacusis disability in adulthood: a retrospective exploratory analysis.

Parental separation and parental mental health in childhood and tinnitus and hyperacusis disability in adulthood: a retrospective exploratory analysis.

Int J Audiol. 2018 Oct 01;:1-6

Authors: Aazh H, Langguth B, Danesh AA

Abstract
OBJECTIVES: To explore the relationships between parental separation and parental mental health in childhood with tinnitus and hyperacusis disability in adulthood.
DESIGN: Retrospective cross-sectional.
STUDY SAMPLE: The data for consecutive patients who attended a tinnitus and hyperacusis clinic in the UK over a six months period were included (n = 184).
RESULTS: 14.7% of patients reported that while they were growing up, their parents were separated or divorced. There were no significant differences in Tinnitus Handicap Inventory (THI) and Hyperacusis Questionnaire (HQ) between patients with and without history of parental separation. About 40.2% reported history of mental health disorders in their parents. The scores on THI and HQ were worse in the group that reported mental health disorders in their parents (p < .01). Parental mental health illness did not significantly relate to THI, however, it was significantly related to the risk of hyperacusis (odds ratio [OR], after adjusting for age and gender: 2.05, p = .026). The adjusted OR for a subgroup of patients with a diagnosis of hyperacusis was 6.7 (p = .011), indicating a stronger relationship for this subgroup.
CONCLUSIONS: Among patients seeking help for their tinnitus and hyperacusis, poor parental mental health was associated with increased hyperacusis disability.

PMID: 30272507 [PubMed - as supplied by publisher]

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Parental separation and parental mental health in childhood and tinnitus and hyperacusis disability in adulthood: a retrospective exploratory analysis.

Parental separation and parental mental health in childhood and tinnitus and hyperacusis disability in adulthood: a retrospective exploratory analysis.

Int J Audiol. 2018 Oct 01;:1-6

Authors: Aazh H, Langguth B, Danesh AA

Abstract
OBJECTIVES: To explore the relationships between parental separation and parental mental health in childhood with tinnitus and hyperacusis disability in adulthood.
DESIGN: Retrospective cross-sectional.
STUDY SAMPLE: The data for consecutive patients who attended a tinnitus and hyperacusis clinic in the UK over a six months period were included (n = 184).
RESULTS: 14.7% of patients reported that while they were growing up, their parents were separated or divorced. There were no significant differences in Tinnitus Handicap Inventory (THI) and Hyperacusis Questionnaire (HQ) between patients with and without history of parental separation. About 40.2% reported history of mental health disorders in their parents. The scores on THI and HQ were worse in the group that reported mental health disorders in their parents (p < .01). Parental mental health illness did not significantly relate to THI, however, it was significantly related to the risk of hyperacusis (odds ratio [OR], after adjusting for age and gender: 2.05, p = .026). The adjusted OR for a subgroup of patients with a diagnosis of hyperacusis was 6.7 (p = .011), indicating a stronger relationship for this subgroup.
CONCLUSIONS: Among patients seeking help for their tinnitus and hyperacusis, poor parental mental health was associated with increased hyperacusis disability.

PMID: 30272507 [PubMed - as supplied by publisher]

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via IFTTT

Parental separation and parental mental health in childhood and tinnitus and hyperacusis disability in adulthood: a retrospective exploratory analysis.

Parental separation and parental mental health in childhood and tinnitus and hyperacusis disability in adulthood: a retrospective exploratory analysis.

Int J Audiol. 2018 Oct 01;:1-6

Authors: Aazh H, Langguth B, Danesh AA

Abstract
OBJECTIVES: To explore the relationships between parental separation and parental mental health in childhood with tinnitus and hyperacusis disability in adulthood.
DESIGN: Retrospective cross-sectional.
STUDY SAMPLE: The data for consecutive patients who attended a tinnitus and hyperacusis clinic in the UK over a six months period were included (n = 184).
RESULTS: 14.7% of patients reported that while they were growing up, their parents were separated or divorced. There were no significant differences in Tinnitus Handicap Inventory (THI) and Hyperacusis Questionnaire (HQ) between patients with and without history of parental separation. About 40.2% reported history of mental health disorders in their parents. The scores on THI and HQ were worse in the group that reported mental health disorders in their parents (p < .01). Parental mental health illness did not significantly relate to THI, however, it was significantly related to the risk of hyperacusis (odds ratio [OR], after adjusting for age and gender: 2.05, p = .026). The adjusted OR for a subgroup of patients with a diagnosis of hyperacusis was 6.7 (p = .011), indicating a stronger relationship for this subgroup.
CONCLUSIONS: Among patients seeking help for their tinnitus and hyperacusis, poor parental mental health was associated with increased hyperacusis disability.

PMID: 30272507 [PubMed - as supplied by publisher]

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Parental separation and parental mental health in childhood and tinnitus and hyperacusis disability in adulthood: a retrospective exploratory analysis

.


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Parental separation and parental mental health in childhood and tinnitus and hyperacusis disability in adulthood: a retrospective exploratory analysis

.


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Mechanical Work, Kinematics, and Kinetics during Sit-to-Stand in Children with and without Spastic Diplegic Cerebral Palsy

Publication date: Available online 1 October 2018

Source: Gait & Posture

Author(s): Duangporn Suriyaamarit, Sujitra Boonyong

Abstract

Background

Sit-to-stand (STS) is one of the most common fundamental activity in daily life. The pathology of the neuromuscular control system in children with spastic diplegic cerebral palsy (SDCP) could contribute to atypical movement patterns leading to the inefficiency performance including the STS task. However, there was also a lack of evidence about kinematics, kinetics, and especially mechanical work during the STS task in children with SDCP aged 7-12 years old.

Research question

What were the differences in mechanical work, kinematics and kinetics during STS task between children with SDCP and typically developing (TD) children?

Methods

Eleven children with SDCP (GMFCS I-II) and eleven age and gender-matched control TD children with an age range of 7-12 years were enrolled. Motion analysis and force plate systems were used to collect data. All participants performed the STS task from an adjustable chair. Independent sample t-test and two-way analysis of variance were used in this study.

Results

The children with SDCP took a longer time and used more mechanical work during STS than TD children. At the beginning of the STS task, children with SDCP showed more trunk flexion and posterior pelvic tilting; in addition, during the STS task they also presented more trunk, hip, and knee flexion than TD children. However, the children with SDCP showed less ankle dorsiflexion compared with TD children. For the kinetic variables, asymmetry was found in children with SDCP. The maximum hip and knee extension moment, plantar flexion moment, and peak vertical ground reaction force (GRF) of the non-dominant leg were higher than the values of the dominant leg in these children.

Significance

Even though, children with SDCP who are able to independently STS. They were also a mechanically less efficient performance during STS task. Therefore, this task still needs to be trained during rehabilitation sessions.

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Functional, Impulse-Based Quantification of Plantar Pressure Patterns in Typical Adult Gait

Publication date: Available online 1 October 2018

Source: Gait & Posture

Author(s): A.H. Vette, M. Funabashi, J. Lewicke, B. Watkins, M. Prowse, G. Harding, A. Silveira, M. Saraswat, S. Dulai

ABSTRACT

Background

Dynamic pedobarography is used to measure the change in plantar pressure distribution during gait. Clinical methods of pedobarographic analysis lack, however, a standardized, functional segmentation or require costly motion capture technology and expertise. Furthermore, while commonly used pedobarographic measures are mostly based on peak pressures, progressive foot deformities also depend on the duration the pressure is applied, which can be quantified via impulse measures.

Research Question

Our objectives were to: (1) develop a standardized method for functionally segmenting pedobarographic data during gait without the need for motion capture; (2) compute pedobarographic measures that are based on each segment’s vertical impulse; and (3) obtain a normative set of such pedobarographic measures for non-disabled gait.

Methods

Pedobarographic data was collected during gait from sixty adults with normal feet. Using the maximum pressure map for each trial, an expert and novice rater independently identified the hallux, heel, medial forefoot, and lateral forefoot and computed nine normalized vertical impulse measures.

Results

From the computed impulse measures, the Heel-to-Forefoot Balance was 33.3 ± 5.5%, the Medial-Lateral Forefoot Balance (with hallux) 59.2 ± 8.0%, the Medial-Lateral Forefoot Balance (without hallux) 53.5 ± 7.7%, and the Hallux-to-Medial Forefoot Balance 21.0 ± 8.9% (mean ± standard deviation). The intra- and inter-rater reliability ranged between 0.93 and 1.00 and between 0.89 and 0.99, respectively (ICC(2,1)).

Significance

We developed a simple, stand-alone method for pedobarographic segmentation that is mechanistically linked to relevant anatomical regions of the foot. The normative impulse measures exhibited excellent reliability. This normative dataset is currently used in the clinical assessment of different foot deformities and gait impairments, and in the evaluation of treatment outcomes.

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Bayesian classification of falls risk

Publication date: Available online 1 October 2018

Source: Gait & Posture

Author(s): Matthew Martinez, Phillip L. De Leon, David Keeley

Abstract

Background: Prior research in falls risk prediction often relies on qualitative and/or clinical methods. There are two challenges with these methods. First, qualitative methods typically use falls history to determine falls risk. Second, clinical methods do not quantify the uncertainty in the classification decision. In this paper, we propose using Bayesian classification to predict falls risk using vectors of gait variables shown to contribute to falls risk. Research Questions: (1) Using a vector of risk ratios for specific gait variables shown to contribute to falls risk, how can older adults be classified as low or high falls risk? and (2) how can the uncertainty in the classifier decision be quantified when using a vector of gait variables? Methods: Using a pressure sensitive walkway, biomechanical measurements of gait were collected from 854 adults over the age of 65. In our method, we first determine low and high falls risk labels for vectors of risk ratios using the k-means algorithm. Next, the posterior probability of low or high falls risk class membership is obtained from a two component Gaussian Mixture Model (GMM) of gait vectors, which enables risk assessment directly from the underlying biomechanics. We classify the gait vectors using a threshold based on Youden's J statistic. Results: Through a Monte Carlo simulation and an analysis of the receiver operating characteristic (ROC), we demonstrate that our Bayesian classifier, when compared to the k-means falls risk labels, achieves an accuracy greater than 96% at predicting low or high falls risk. Significance: Our analysis indicates that our approach based on a Bayesian framework and an individual's underlying biomechanics can predict falls risk while quantifying uncertainty in the classification decision.

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The effect of cervical spine subtypes on center of pressure parameters in a large asymptomatic young adult population

Publication date: Available online 1 October 2018

Source: Gait & Posture

Author(s): Lee Daffin, Max C Stuelcken, Mark G L Sayers

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Mechanical Work, Kinematics, and Kinetics during Sit-to-Stand in Children with and without Spastic Diplegic Cerebral Palsy

Publication date: Available online 1 October 2018

Source: Gait & Posture

Author(s): Duangporn Suriyaamarit, Sujitra Boonyong

Abstract

Background

Sit-to-stand (STS) is one of the most common fundamental activity in daily life. The pathology of the neuromuscular control system in children with spastic diplegic cerebral palsy (SDCP) could contribute to atypical movement patterns leading to the inefficiency performance including the STS task. However, there was also a lack of evidence about kinematics, kinetics, and especially mechanical work during the STS task in children with SDCP aged 7-12 years old.

Research question

What were the differences in mechanical work, kinematics and kinetics during STS task between children with SDCP and typically developing (TD) children?

Methods

Eleven children with SDCP (GMFCS I-II) and eleven age and gender-matched control TD children with an age range of 7-12 years were enrolled. Motion analysis and force plate systems were used to collect data. All participants performed the STS task from an adjustable chair. Independent sample t-test and two-way analysis of variance were used in this study.

Results

The children with SDCP took a longer time and used more mechanical work during STS than TD children. At the beginning of the STS task, children with SDCP showed more trunk flexion and posterior pelvic tilting; in addition, during the STS task they also presented more trunk, hip, and knee flexion than TD children. However, the children with SDCP showed less ankle dorsiflexion compared with TD children. For the kinetic variables, asymmetry was found in children with SDCP. The maximum hip and knee extension moment, plantar flexion moment, and peak vertical ground reaction force (GRF) of the non-dominant leg were higher than the values of the dominant leg in these children.

Significance

Even though, children with SDCP who are able to independently STS. They were also a mechanically less efficient performance during STS task. Therefore, this task still needs to be trained during rehabilitation sessions.

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Functional, Impulse-Based Quantification of Plantar Pressure Patterns in Typical Adult Gait

Publication date: Available online 1 October 2018

Source: Gait & Posture

Author(s): A.H. Vette, M. Funabashi, J. Lewicke, B. Watkins, M. Prowse, G. Harding, A. Silveira, M. Saraswat, S. Dulai

ABSTRACT

Background

Dynamic pedobarography is used to measure the change in plantar pressure distribution during gait. Clinical methods of pedobarographic analysis lack, however, a standardized, functional segmentation or require costly motion capture technology and expertise. Furthermore, while commonly used pedobarographic measures are mostly based on peak pressures, progressive foot deformities also depend on the duration the pressure is applied, which can be quantified via impulse measures.

Research Question

Our objectives were to: (1) develop a standardized method for functionally segmenting pedobarographic data during gait without the need for motion capture; (2) compute pedobarographic measures that are based on each segment’s vertical impulse; and (3) obtain a normative set of such pedobarographic measures for non-disabled gait.

Methods

Pedobarographic data was collected during gait from sixty adults with normal feet. Using the maximum pressure map for each trial, an expert and novice rater independently identified the hallux, heel, medial forefoot, and lateral forefoot and computed nine normalized vertical impulse measures.

Results

From the computed impulse measures, the Heel-to-Forefoot Balance was 33.3 ± 5.5%, the Medial-Lateral Forefoot Balance (with hallux) 59.2 ± 8.0%, the Medial-Lateral Forefoot Balance (without hallux) 53.5 ± 7.7%, and the Hallux-to-Medial Forefoot Balance 21.0 ± 8.9% (mean ± standard deviation). The intra- and inter-rater reliability ranged between 0.93 and 1.00 and between 0.89 and 0.99, respectively (ICC(2,1)).

Significance

We developed a simple, stand-alone method for pedobarographic segmentation that is mechanistically linked to relevant anatomical regions of the foot. The normative impulse measures exhibited excellent reliability. This normative dataset is currently used in the clinical assessment of different foot deformities and gait impairments, and in the evaluation of treatment outcomes.

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via IFTTT

Bayesian classification of falls risk

Publication date: Available online 1 October 2018

Source: Gait & Posture

Author(s): Matthew Martinez, Phillip L. De Leon, David Keeley

Abstract

Background: Prior research in falls risk prediction often relies on qualitative and/or clinical methods. There are two challenges with these methods. First, qualitative methods typically use falls history to determine falls risk. Second, clinical methods do not quantify the uncertainty in the classification decision. In this paper, we propose using Bayesian classification to predict falls risk using vectors of gait variables shown to contribute to falls risk. Research Questions: (1) Using a vector of risk ratios for specific gait variables shown to contribute to falls risk, how can older adults be classified as low or high falls risk? and (2) how can the uncertainty in the classifier decision be quantified when using a vector of gait variables? Methods: Using a pressure sensitive walkway, biomechanical measurements of gait were collected from 854 adults over the age of 65. In our method, we first determine low and high falls risk labels for vectors of risk ratios using the k-means algorithm. Next, the posterior probability of low or high falls risk class membership is obtained from a two component Gaussian Mixture Model (GMM) of gait vectors, which enables risk assessment directly from the underlying biomechanics. We classify the gait vectors using a threshold based on Youden's J statistic. Results: Through a Monte Carlo simulation and an analysis of the receiver operating characteristic (ROC), we demonstrate that our Bayesian classifier, when compared to the k-means falls risk labels, achieves an accuracy greater than 96% at predicting low or high falls risk. Significance: Our analysis indicates that our approach based on a Bayesian framework and an individual's underlying biomechanics can predict falls risk while quantifying uncertainty in the classification decision.

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The effect of cervical spine subtypes on center of pressure parameters in a large asymptomatic young adult population

Publication date: Available online 1 October 2018

Source: Gait & Posture

Author(s): Lee Daffin, Max C Stuelcken, Mark G L Sayers

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